Vascular Neurology Nurse Practitioner Provision of Telemedicine Consultations

Abstract EN

Objective.

The objective was to define and evaluate a role for the Vascular Neurology-Nurse Practitioner (VN-NP) in the delivery of telemedicine consultations in partnership with a vascular neurologist.

Methods.

Prospective stroke alert patients at participating hospitals underwent a two-way audio video telemedicine consultation with a VN-NP at a remotely located stroke center in partnership with a vascular neurologist.

Demographic information, National Institutes of Health Stroke Scale (NIHSS) scores, diagnoses, CT contraindications to thrombolysis, thrombolysis eligibility, and time interval data were collected.

The inter-rater agreement between VN-NP and vascular neurologist assessments was calculated.

Results.

Ten patients were evaluated.

Four were determined to have ischemic stroke, one had a transient ischemic attack, two had intracerebral hemorrhages, and three were stroke mimics.

Overall, three patients received thrombolysis.

The inter-rater agreement between VN-NP and vascular neurologist assessments were excellent, ranging from 0.9 to 1.0.

The duration of VN-NP consultation was 53.2±9.0 minutes, which included the vascular neurologist supervisory evaluation time of 12.0±9.6 minutes.

Conclusion.

This study illustrated that a stroke center VN-NP, in partnership with a vascular neurologist, could deliver timely telemedicine consultations, accurate diagnoses, and correct treatments in acute stroke patients who presented to remotely located rural emergency departments within a hub and spoke network.

VN-NPs may fulfill the role of a telestroke provider.